News and Answers

Healthcare insurance rate increases and a scarcity of offered plans will dominate the news in the coming weeks. What does this mean for you? Find out your options and beat the deadlines by contacting your agent as soon as possible. Many individuals and families will recieve notices of nonrenewal this month as the Open [...]

Many healthcare plans will not be renewing for the 2017 year and members with the following carriers have already received a Letter of Termination. If you are insured by one of these plans, it is urgent that you contact your agent to choose and enroll in a different plan for the 2017 year. Aetna, [...]

“What is my penalty if I don’t buy medical coverage?” Here are the updates: We usually answer questions about doctors, hospitals and deductibles, but in the age of Healthcare Reform, tax penalties are now a consequence if you don’t follow the law regarding owning a healthcare policy. There is a penalty for each month you and your [...]

After a few years of insurance mandates, tax penalties and rising premiums, insureds are wondering what the future holds for healthcare for their own household. The question of the day is: How will the election affect my insurance premium? To begin, it helps to understand why politics affects healthcare in the U.S. The passage [...]

Now that the Affordable Care Act has relaxed the eligibility requirements to qualify for Medicaid, so many people are coming to take advantage of it that states are now getting worried. The Associated Press reports Washington, D.C. and 31 states have expanded Medicaid, meaning lots more low-income people now have coverage than before the ACA’s passage. [...]

Open Enrollment is quickly approaching and insurance carriers are beginning to reach out to clients regarding their coverage and plan options for 2017. In October, CMS will send a Marketplace Open Enrollment Notice (MOEN) to all on-Exchange members. This notice will contain certain basic information, including: a description of the annual redetermination and renewal process; [...]

One of the Obama administration’s numerous experiments to reduce the cost of Medicare has provoked fury from cancer doctors. The administration announced last month it would be trying out a new model to reimburse doctors and providers for the cost of medications administered at outpatient facilities, typically expensive cancer treatments that are delivered intravenously at [...]

What are the trends driving change in the healthcare industry? Here is an excerpt from BenefitsPro author REID RASMUSSEN commenting on the trends he identifies as the most impactful factors in this year's healthcare environment: All around the country, brokers ask where the industry is going? They want to know if other states are seeing the same [...]

Our business clients can keep their current benefit plans even longer Earlier this year, guidance from the Center for Medicare & Medicaid Services (CMS) brought news related to non-ACA (Affordable Care Act) benefit plans. This guidance means that certain employer groups (up to and including 50) can keep their current medical benefit plans and continue to be [...]

Drug shortages in U.S. emergency rooms increased by more than 400 percent between 2001 and 2014, a new study finds. The study, published in Academic Emergency Medicine, a medical journal, found more than 1,800 reported drug shortages during the 13-year timeframe. Just over a third of the reported shortages came from emergency departments, and in [...]

Health insurance for the masses continues to be a good deal for most, at least when coverage policies are judged by their premiums. A new U.S. Department of Health and Human Services report says that users of the HealthCare.gov insurance site “are actively shopping and saving money,” a sign that Americans are becoming increasingly savvy about [...]

Cost Sharing Reductions and Premium Assistance is renewable for qualified insureds on their 2016 plans, but only if certain criteria are met. Last year we assisted many healthcare insurance subscribers receive a federal tax credit or income-based cost sharing reduction (CSR) to assist in keeping the cost of medical care affordable. The benefits do have [...]

Healthcare Reform and the quest to reduce waste is back in the news today. The ACA has produced some tumultuous results in the healthcare industry as reported by Insurance Business America in the following report by Jill Gregorie. Our analysis follows the report. "Anthem Inc has agreed to purchase Cigna Corp for $54.2 billion in a [...]

News for patients using Humana networks: Last October we had to notify our Humana clients that Florida Hospital had not continued their contract with Humana, but now we are happy to report that Florida Hospital and Humana are working together again. Central Floridians who have Humana health insurance can once again pay in-network fees at [...]

Aetna and Humana Inc. announced on July 3 that they have entered into a definitive agreement under which Aetna will acquire all outstanding shares of Humana for a combination of cash and stock valued at $37 billion or approximately $230 per Humana share based on the closing price of Aetna common shares on July 2, 2015. In a [...]

New announcement The Centers for Medicare and Medicaid Services on Friday morning announced it will implement a special enrollment period for individuals who learn, at the time they file their taxes, of the Affordable Care Act-mandated tax penalty for not having health insurance coverage. The special enrollment period will allow people to sign up as [...]

Knowing the cost of NOT owning health coverage is now a factor in deciding on your medical plan. Plan ahead for Open Enrollment "What is my penalty if I don't buy medical coverage?" Certainly not the most asked question we receive in our insurance office. After all, our business is to help people get [...]

Florida Hospital will no longer be included in Humana's network Last month Florida Hospital notified Humana that effective October 18, 2014 it would no longer be part of Humana’s commercial HMO, PPO, EPO and POS provider network. Although there were discussions to retain in-network access to these hospitals for Humana members, an agreement [...]

A delayed, but inevitable, result of the The Affordable Care Act is a provision which requires employers to make reports to the IRS regarding the health care situation for each of their employees. The reporting begins in 2016, but employers should begin now to prepare for their compliance. The instructions portions of the reporting requirement have been anticipated [...]

If you have coverage from a job (or a family member’s job): You will not owe a fee because you have met the Shared Responsibility Provision. With job-based insurance, you are considered covered and won’t have to pay the fee that uninsured people must pay. You may also purchase your own healthcare insurance. You [...]

The Affordable Care Act’s Open Enrollment Period had a tumultuous and confusing beginning. In addition, several last minute changes in applying the law left many scrambling to understand their options after December 2013. Here are seven things that you need to know and are still true now that the New Year is upon us: [...]

Glossary of Health Insurance Terms actuary - a mathematician in the insurance field. Responsible for calculating premiums, developing plans and defining underwriting risk. Affordable Care Act - The comprehensive health care reform law enacted in March 2010. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law [...]

Next week's public session is sponsored by our host, Legal One. You are invited to bring guests to these informative sessions updating the latest provisions of Healthcare Reform. Our informational session is presented regularly at community events, business groups and at workplaces throughout Florida. Contact us if you would like to schedule a presentation: 407-937-2900. See Craig Rodrigue's [...]

The latest updates on Healthcare Reform are presented at our "Affordable Care Act 101" presentations. Join us this week when we are hosted by accounting and tax expert ATI Professional Services Inc. We will present valuable information regarding mandates, subsidies, and new updates on the deadlines for 2014 and beyond. Learn how to choose your [...]

Insurance? Exchanges? Metallic Choices? You are not on your own to sort out the new era of Healthcare Reform! You do have options and even more choices than you have seen advertised with huge marketing campaigns. Yes, you may be eligible for tax credits to help pay premiums or cost sharing to help pay [...]

What is Modified Adjusted Gross Income? The magic number needed for those seeking to receive assistance with their new health insurance premiums under the ACA (also known as "Obamacare") is not simply one's household income. It is defined as something called "Modified Adjusted Gross Income". This number does not appear as a line item on [...]

Can I really get free help? Insurance inside and outside the Exchange can be purchased with the help of an insurance agent. Those applying for government subsidies will buy Exchange plans, but there are still many options worth considering among the plans and consumers are wise not to go it alone. Insurance agents are [...]

What is the advantage of buying a policy on the Exchange and when can that actually be done? Individuals have choices of both On Exchange and Off Exchange insurance coverage for themselves and their families. "On Exchange" describes policies that can be issued to those who accept an advance premium tax credit, also called a subsidy, [...]

We're nearing the finish line - less than one week left until Small Groups will leave the "pre-reform" pricing and designs of their Medical Plans and begin renewing under the ACA regulated insurance environment. Here is a brief Background behind the deadline: Affordable Care Act (ACA) is bringing inevitable change to the health care system including: New benefit requirements under [...]

Individuals and Small Businesses with health insurance coverage are acting to take advantage of one last chance to keep their current policies, and premium rates, for the year 2014. Why the rush? Because insurance customers are required to buy the new ACA mandated plans at their first renewal in 2014. By taking advantage of early [...]

AFL-CIO Convention. Photo credit Getty Images Whenever a new discussion erupts about Healthcare Reform, it is important to look at basic intent of the law to understand both the actions and the consequences of lawmakers. This week’s news stories regarding the rejection of Union requests for exceptions to the Affordable Care Act (ACA) [...]

Insurance plans will be designed for more comprehensive consumer comparisons Insurance plans in the Marketplace are offered by private companies. They cover the same core set of benefits called Essential Health Benefits. No plan can turn you away or charge you more because you have an illness or medical condition. They must cover treatments [...]

Beginning September 1, 2013 CSR & Associates will remove News Blog posts from previous years and begin adding posts specific to the current environment of Healthcare Insurance. Regulations and taxing under the Patient Protection and Affordable Care Act (sometimes referred to as “Obamacare” ) have affected the medical supplies market, the collection of health records and the [...]

Or, The Shared Responsibility Provision The IRS addresses this provision of the Affordable Care Act (ACA) as follows: Under the Affordable Care Act, the federal government, state governments, insurers, employers and individuals are given shared responsibility to reform and improve the availability, quality and affordability of health insurance coverage in the United States. Starting [...]

How your Insurance Plan will look in 2014 The Affordable Care Act (ACA) requires that non-grandfathered health insurance plans offered in the individual and small group markets (both inside and outside of the Exchanges) provide a package of health care services, known as “Essential Health Benefits” (EHB). More specifically, we use the term "10 Essential Health [...]

Questions about Healthcare Reform Note: See Important Update at the End of this Article! “You can keep your insurance if you like it” became a popular phrase during the political season leading up to the passage of the Affordable Care Act (ACA) in 2010. The phrase became so tied to healthcare reform that we are [...]

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CSR & Associates, The Benefits Group is an insurance agency dedicated to meeting the insurance protection needs of employers, individuals and families. Our agency is distinguished by our ability to identify your insurance needs and bring to you the most beneficial protection available, at the most reasonable cost, with the highest quality of professional service.